David Morgan
WASHINGTON (Reuters) – Republican concerns about losing their majority in the U.S. House of Representatives next year erupted this week as four moderates joined Democrats in a last-ditch effort to prevent a surge in health care costs that will begin for 24 million Americans in less than two weeks.
The four — Reps. Rob Bresnahan, Brian Fitzpatrick and Ryan Mackenzie of Pennsylvania and Mike Lawler of New York Lawler) — is part of a larger group of about a dozen House Republicans who have been pushing for their own bipartisan reforms aimed at protecting voters in swing districts by extending health subsidies that are set to expire after Dec. 31 under the Affordable Care Act, also known as Obamacare.
They represent a small but crucial portion of the House of Representatives, representing about three dozen of the 435 seats expected to be up for grabs in the November midterm elections that will determine whether President Donald Trump’s Republicans hold a majority or Democrats seize the majority.
But they were unable to reach a deal with Republican leaders, who sought conservative restrictions that lawmakers viewed as unpalatable.
“We want to vote up or down,” said Lawler, whose district in northern New York City faces an unpredictable election. “Unfortunately, leadership is doing everything they can to not let that happen. So we have no choice but to sign a clean three-year (Democratic) extension and force a vote.”
Independent analysts say Republicans already face electoral headwinds given Trump’s declining approval ratings, public dissatisfaction with rising prices and a political cycle that often punishes the sitting president’s party.
Trump’s party is working to overcome this historical pattern, including launching a campaign to redraw congressional districts in Republican-held states in their favor, a move that Democrats are scrambling to oppose.
Subsidy is about to expire
Moderate House Republicans, who are crucial to their control of Capitol Hill, face greater risks because Congress is unable to extend health subsidies or curtail the steep increases in private health insurance premiums for Affordable Care Act beneficiaries that began Jan. 1.
“If there’s a ‘blue wave’ next year, members in contested seats will pay the price, even if they are the ones who want to restore Obamacare subsidies,” said Kyle Kondik, a political analyst at the University of Virginia Center for Politics.
“They want to at least be able to say publicly, ‘Hey, I voted to extend these subsidies,'” Kondik added.
A bill introduced by House Democratic Leader Hakeem Jeffries and signed by moderates has failed in the Senate.
Moderates hope House approval will spur a bipartisan compromise that can pass both chambers, which analysts say would help people facing skyrocketing health insurance premiums. But there’s no guarantee of agreement on an issue that lawmakers have been unable to resolve for months, and health care costs will start to rise before the vote.
House passes partisan bill
Instead, the House passed a partisan health care bill aimed at lowering premiums for some while reducing overall subsidies and raising premiums for others starting in January 2027, two months after the November election.
House Speaker Mike Johnson insisted he was committed to getting moderates to vote on his legislation, denying that they might be more vulnerable to Democratic influence in the midterm elections after Affordable Care Act subsidies expire.
“These are extraordinary people. They know how to run a campaign, and they’re going to have a good campaign record,” Johnson told Reuters, adding that Republicans would vote on more legislation next year aimed at lowering health care costs.
Republican moderates have been reluctant to talk about their efforts to extend Affordable Care Act subsidies in terms of their own reelection prospects.
“We have to fix health care. That’s all I care about. Politics will take care of itself,” Fitzpatrick said, according to the website Ballotpedia. Fitzpatrick’s Pennsylvania district was won by Democrat Kamala Harris in the 2024 presidential election.
Democrats, who see rising health care costs at the center of a powerful campaign issue on affordability, are hoping to capitalize on the inaction of a Republican-controlled Congress on ACA subsidies, potentially repeating their victory in 2018, when they used Republican efforts to repeal Obamacare as an issue to capture House seats.
In a rare evening address on Wednesday, Trump endorsed a Republican proposal to send cash directly to the public rather than to insurance companies to offset the cost of health insurance, seemingly cementing the fate of Affordable Care Act subsidies.
‘A bigger problem’ than the 2018 midterm elections
Democrats will try to blame Republicans for cuts to Medicaid under Trump’s tax cut and spending bill and rising health insurance costs due to the loss of Affordable Care Act subsidies.
“Between the changes in Medicaid and the coming premium spikes, I think this is a bigger problem than what we had in 2018,” said Charlie Dent, a former Republican congressman who now directs the Congressional Project at the Aspen Institute.
With the House currently holding a 220-213 majority, Republicans can afford to lose no more than three seats and still retain control of the House. But they face a dozen close races and many more in which Democrats could pull off unexpected victories.
Democratic incumbents also face unpredictable elections and other races in which Republicans may be competitive.
But analysts say Democrats currently have the upper hand unless Trump makes any breakthrough in his campaign to eliminate Democratic seats through mid-decade redistricting.
Democrats, meanwhile, say they have no doubts about their chances of winning next November.
“They’re going to lose the House. Hakeem Jeffries is going to be speaker,” said Democratic Rep. Nancy Pelosi, who won a rare reelection as speaker after Democrats took control of the House in 2018.
“There’s no doubt it’s because of health care. Well, health care, affordability and corruption,” she told Reuters.
(Reporting by David Morgan; Editing by Scott Malone and Alistair Bell)
